Osteotomía intertrocantérea de traslación

Los autores analizan los efectos de la osteotomía intertrocantérea de traslación en el tratamiento de la coxartrosis y los clasifican en vasculonerviosos, estaticodinámicos y distales. Presentan su experiencia en dos series de caderas, inviables o destruidas y viables o con posibilidades reconstructivas. Estudian y comentan los resultados comparativamente con otras series de la literatura y delimitan las indicaciones actuales de la intervención en espera a veces del tiempo de prótesis total

Osteosíntesis y artrolisis en el tratamiento de las fracturas supra e intercondíleas graves del codo en el adulto

Los autores estudian la evoluciónen el tratamiento de las fracturas graves de la extremidad distal del hiimero hasta llegar a la técnica actual de la osteosíntesis estable. Presentan y analizan una serie de 21 fracturas condíleas, supracondíleas y supraintercondíleas tratadas quirtirgicamente mediante abordaje por vía transolecraniana, osteosíntesis con placas y tornillos y fijación del olécranon con compresión. La movilización precoz postoperatoria favorece la obtención de un buen arco móvil. Se obtienen resultados buenos en 13 casos el 62 % de la serie , rigidez en cuatro casos y fracaso definitivo en cuatro casos. Se estudian las posibilidades de la resección de las osificaciones y la artrólisis con un criterio biológico y se aplica para solucionar los cuatro casos. Se obtiene una mejoría en todos ellos y el análisis final de la serie eleva los buenos resultados al 70 % de casos. El estudio de los fracasos busca la causalidad de la intervención sin hallarla claramente. Se concluye sobre la necesaria indicación en tales fracturas del tratamiento cruento con osteosíntesis estable y del recurso de la artrólisis para mejorar los fracasos parciales y no definitivos

Alignment of the Pixel and SCT Modules for the 2004 ATLAS Combined Test Beam

A small set of final prototypes of the ATLAS Inner Detector silicon tracker (Pixel and SCT) were used to take data during the 2004 Combined Test Beam. Data were collected from runs with beams of different flavour (electrons, pions, muons and photons) with a momentum range of 2 to 180 GeV/c. Four independent methods were used to align the silicon modules. The corrections obtained were validated using the known momenta of the beam particles and were shown to yield consistent results among the different alignment approaches. From the residual distributions, it is concluded that the precision attained in the alignment of the silicon modules is of the order of 5 micrometers in their most precise coordinate.Comment: 22 pages, submitted to JINST, 129 author

Choice of the initial antiretroviral treatment for HIV-positive individuals in the era of integrase inhibitors

BACKGROUND: We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. METHODS: We analyzed initial ART regimens prescribed in adults participating in CoRIS from 2014 to 2017. Only regimens prescribed in >5% of patients were considered. We used multivariable multinomial regression to estimate Relative Risk Ratios (RRRs) for the association between sociodemographic and clinical characteristics and the choice of the initial regimen. RESULTS: Among 2874 participants, abacavir(ABC)/lamivudine(3TC)/dolutegavir(DTG) was the most frequently prescribed regimen (32.1%), followed by tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/elvitegravir(EVG)/cobicistat(COBI) (14.9%), TDF/FTC/rilpivirine (RPV) (14.0%), tenofovir alafenamide (TAF)/FTC/EVG/COBI (13.7%), TDF/FTC+DTG (10.0%), TDF/FTC+darunavir/ritonavir or darunavir/cobicistat (bDRV) (9.8%) and TDF/FTC+raltegravir (RAL) (5.6%). Compared with ABC/3TC/DTG, starting TDF/FTC/RPV was less likely in patients with CD4100.000 copies/mL. TDF/FTC+DTG was more frequent in those with CD4100.000 copies/mL. TDF/FTC+RAL and TDF/FTC+bDRV were also more frequent among patients with CD4<200 cells//muL and with transmission categories other than men who have sex with men. Compared with ABC/3TC/DTG, the prescription of other initial ART regimens decreased from 2014-2015 to 2016-2017 with the exception of TDF/FTC+DTG. Differences in the choice of the initial ART regimen were observed by hospitals' location. CONCLUSIONS: The choice of initial ART regimens is consistent with Spanish guidelines' recommendations, but is also clearly influenced by physician's perception based on patient's clinical and sociodemographic variables and by the prescribing hospital location

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Osteotomía intertrocantérea de traslación

Los autores analizan los efectos de la osteotomía intertrocantérea de traslación en el tratamiento de la coxartrosis y los clasifican en vasculonerviosos, estaticodinámicos y distales. Presentan su experiencia en dos series de caderas, inviables o destruidas y viables o con posibilidades reconstructivas. Estudian y comentan los resultados comparativamente con otras series de la literatura y delimitan las indicaciones actuales de la intervención en espera a veces del tiempo de prótesis total

Osteosíntesis y artrolisis en el tratamiento de las fracturas supra e intercondíleas graves del codo en el adulto

Los autores estudian la evoluciónen el tratamiento de las fracturas graves de la extremidad distal del hiimero hasta llegar a la técnica actual de la osteosíntesis estable. Presentan y analizan una serie de 21 fracturas condíleas, supracondíleas y supraintercondíleas tratadas quirtirgicamente mediante abordaje por vía transolecraniana, osteosíntesis con placas y tornillos y fijación del olécranon con compresión. La movilización precoz postoperatoria favorece la obtención de un buen arco móvil. Se obtienen resultados buenos en 13 casos el 62 % de la serie , rigidez en cuatro casos y fracaso definitivo en cuatro casos. Se estudian las posibilidades de la resección de las osificaciones y la artrólisis con un criterio biológico y se aplica para solucionar los cuatro casos. Se obtiene una mejoría en todos ellos y el análisis final de la serie eleva los buenos resultados al 70 % de casos. El estudio de los fracasos busca la causalidad de la intervención sin hallarla claramente. Se concluye sobre la necesaria indicación en tales fracturas del tratamiento cruento con osteosíntesis estable y del recurso de la artrólisis para mejorar los fracasos parciales y no definitivos